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Robotic Telesurgery Live at OHA Convention

November 05, 2001

Debbie Neufert
Media Relations, LHSC
519-685-8500, ext. 74772

Canada's new National Surgical Robotics Centre demonstrates telementoring in surgery

(LONDON, Ontario) - Sharing the remote takes on new meaning with the latest in robotic technology demonstrated by London doctors today at the Ontario Hospital Association (OHA) Convention in Toronto. In a live demonstration, doctors from London Health Sciences Centre (LHSC), a world leader in robotic surgery, and the new national surgical robotics centre in London, Canadian Surgical Technologies and Advanced Robotics (CSTAR), showed how the new frontier of robotic surgery is going to change the face of health care.

Dr. Reiza Rayman, CSTAR Director of Research and Business Operations, and Dr. Richard Malthaner, LHSC Thoracic Surgeon, showcased the technology of robotics and telementoring in surgery. The robots used were the voice-controlled AESOP endoscope positioning system, and the SOCRATES Robotic Telecollaboration System by Computer Motion.

Dr. Rayman was in Toronto and guided Dr. Malthaner through a lung biopsy 200 kilometres away in an operating room at the University Campus of LHSC. Both doctors were able to see and hear one another through videoconferencing technology. Using the robot called SOCRATES, Dr. Rayman had remote manipulation of the AESOP robotic endoscopic camera inside the patient in London. The technology of telestration allowed Dr. Rayman to draw on an electronic tablet to point out anatomical landmarks on the view from the endoscopic camera to Dr. Malthaner. The telestration drawings appear simultaneously on the video output that Dr. Malthaner sees in the operating room.

Dr. Rayman says, "Robotics is allowing us to create the next step in minimally-invasive surgery. The SOCRATES and AESOP robotic technology has opened the door to the future where surgical expertise can be offered virtually anywhere without actually having to travel."

In February of this year, Dr. Malthaner was one of the surgeons involved in the world's first surgery to use telementoring using the remote control technology of the SOCRATES robot. Dr. Malthaner says, "Telementoring and telesurgery provides a live, second opinion in the operating room. For patients, it means the expert comes to the patient, instead of the patient to the expert."

LHSC President and CEO, Tony Dagnone, says, "Our vision for the future is that surgical robotics will allow a major teaching centre like LHSC to mentor surgeons in community hospitals. The patients will also benefit by receiving care right where they live."

CSTAR is a joint effort between LHSC and the Lawson Health Research Institute (LHRI) in London. Construction of the new national surgical robotics centre is expected to begin later this fall at LHSC's University Campus. CSTAR will bring together engineers, scientists, information technologists and clinicians working on multidisciplinary project teams to advance surgical robotics. CSTAR will serve as a global nexus for the growth and commercialization of this vital new field of health care that will become the established standard within five to seven years. The new technologies developed at CSTAR will mean shorter hospital stays and improved outcomes for patients, as well as decreased annual health care costs by millions of dollars.

In September 1999, London Health Sciences Centre completed the world's first robotically assisted, closed chest, single coronary bypass surgery on a beating heart. The surgery was the work of Dr. Douglas Boyd, LHSC Cardiac Surgeon, and Director of CSTAR.

Canadian Surgical Technologies & Advanced Robotics - Fact Sheet

  • CSTAR (Canadian Surgical Technologies and Advanced Robotics) is Canada's national centre for developing and testing the next generation of minimally invasive surgical technologies and techniques. CSTAR is the only Canadian facility capable of performing telesurgery, telementoring, and telestration, and one of only seven such centres worldwide. CSTAR is a collaborative effort of London Health Sciences Centre (LHSC) and Lawson Health Research Institute (LHRI).
  • In September 1999, the world’s first robotic-assisted, closed-chest, single coronary bypass surgery on a beating heart was performed at LHSC by Dr. Douglas Boyd, Director, CSTAR.
  • Dr. Boyd's accomplishment is revolutionizing the delivery of cardiac bypass surgery. Since the world-first procedure, Boyd and colleague Dr. Reiza Rayman have performed more than 200 robotic surgeries and 80 heart bypass operations. Up to 25 per cent of the 1,700 single bypass procedures performed annually at London Health Sciences Centre would be candidates for this procedure.
  • In February 2001, surgeons at LHSC performed the world’s first robotic-assisted surgery using the Socrates Robotic Telecollaboration system.
  • Robotic-assisted, minimally invasive surgery provides better quality of life because:
    • patients can undergo heart valve surgery sooner (before significant deterioration)
    • sicker patients, who might not be able to withstand the trauma of conventional open-heart surgery, are good candidates
    • patients recover faster and with less complications from keyhole-sized incisions (3cm), less blood loss, and decreased time on a ventilator
    • patients treated sooner can avoid long-term use of blood thinners
  • CSTAR will occupy two levels of a new five-storey research building at University Campus, London Health Sciences Centre. Infrastructure cost is $12 million and expected completion is late 2002.
  • CSTAR brings together engineers, scientists, information technologists and clinicians working on multidisciplinary teams to advance medical robotics. Currently CSTAR projects have attracted $17.2 million in funding, including grants from the Canada Foundation for Innovation (CFI) and the Ontario Research and Development Fund (ORDCF). Current projects include: Robotic Assisted Cardiac Surgery; Robotic Cancer Therapy and Thoracic Surgery; Telehealth/Telesurgery Study; Robotic Haptics Study; Paediatric Robotic Surgery; Atrial Fibrillation Study
  • CSTAR has great potential to spur the creation of many new surgical methods and products. Over 50 industrial jobs will be created in eight years and over 50 institutional jobs and studentships in three years. Projected commercialization of research activities will contribute a minimum of $30 million over eight years to provincial and local economies.


  • Telementoring—Using video-conferencing technology, an expert surgeon at a remote site can teach robotic and other procedures to second surgeon in an operating room.
  • Telesurgery—Surgery performed by an operating surgeon sitting at a console in a remote location. The remote location can be several feet, or several miles, away from the operating room.
  • Telestration—An illustrative technique which allows the remote mentoring surgeon to use a drawing tablet to make marks on the local surgeon's video monitor. The mentoring surgeon can show where to make an incision or can highlight a tumour mass, for example.


CSTAR's Dr. Reiza Rayman telementored Dr. Richard Malthaner, LHSC Thoracic Surgeon, who was 200 kilometres away in London performing a lung biopsy. Dr.

CSTAR's Dr. Reiza Rayman telementored Dr. Richard Malthaner, LHSC Thoracic Surgeon, who was 200 kilometres away in London performing a lung biopsy. Dr. Rayman also demonstrated the use of Telestration.